Adjusting Wheelchair Set-Up to Minimize Shoulder Joint Forces During Propulsion

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Brief Title

Adjusting Wheelchair Set-Up to Minimize Shoulder Joint Forces During Propulsion

Official Title

Computationally Quantifying Wheelchair Set-Up to Minimize Peak Shoulder Joint Forces Throughout Manual Wheelchair Propulsion: A Pilot Study

Brief Summary

      Individuals who use a manual wheelchair depend upon their upper limbs to provide a means of
      locomotion during completion of their activities of daily living. As a result of greater than
      normal usage of the upper limbs, shoulder pain and pathology is common among manual
      wheelchair users. Accordingly, proper wheelchair set-up may be paramount to preventing
      injuries and maintaining comfort during locomotion.

      The purpose of this research study is to create a subject-specific computer model of
      wheelchair propulsion to provide information on wheelchair set-up (in particular, axle
      placement). The primary objective of this study is to investigate the effect of wheelchair
      set-up on shoulder joint forces during wheelchair propulsion; the secondary objective is to
      develop a predictive model to identify differences in shoulder joint forces that result from
      altering the axle position and seating set-up in user's wheelchairs.

      The hypothesis of the study is that outputs from a patient-specific model will reveal that
      the current axle position for each subject results in peak shoulder joint forces that are
      greater than those predicted from an altered axle position (determined by the model). The
      overall goal is to then adjust each manual wheelchair user's axle placement to one that
      minimizes the magnitude of shoulder joint forces throughout propulsion. It is intended that
      in doing so, the repetitive strain injuries associated with manual wheelchair propulsion may
      be reduced, prolonging a pain-free way of life for this population.

Study Type


Primary Outcome

Peak shoulder joint forces

Secondary Outcome

 Propulsion Speed



Study Arms / Comparison Groups

Description:  Able-bodied participants: Able-bodied individuals will be asked to propel a wheelchair at a self-selected speed for a period of time during which data will be collected on their propulsion biomechanics. It is assumed, for the purpose of the study, that un-learned able-bodied individuals learning to propel a wheelchair reflect newly injured individuals who are just getting accustomed to a new chair.


* Includes publications given by the data provider as well as publications identified by National Clinical Trials Identifier (NCT ID) in Medline.

Recruitment Information

Estimated Enrollment


Start Date

July 2008

Completion Date

July 2010

Primary Completion Date

October 2009

Eligibility Criteria

        Experienced Wheelchair Users:

        Inclusion Criteria:

          -  Have a neurological impairment secondary to a spinal cord injury which occurred over 1
             year prior to the start of the study;

          -  SCI at or below T1 (complete or incomplete);

          -  Use a manual wheelchair as a primary means of mobility (at least 40 hrs. per week but
             not necessarily always in motion);

          -  SCI after age 18

          -  Have 24 inch diameter wheels with quick-release axles.

        Exclusion Criteria:

          -  History of fractures or dislocations in the arms including the shoulder, elbow, and

          -  Upper limb dysthetic pain as a result of a syrinx or reflex sympathetic dystrophy;

          -  Pregnant women;

          -  Shoulder pain that a MWU describes as limiting their ability to propel a manual

          -  History of neurologic disorder other than spinal cord injury (e.g. brain injury).

        Inexperienced Manual Wheelchair Users:

        Inclusion Criteria:

          -  Be between the ages of 18 and 65 years of age.

        Exclusion Criteria:

          -  History of fractures or dislocations in the arms including the shoulder, elbow, and

          -  Have a musculoskeletal disorder;

          -  Pregnant women;

          -  Shoulder pain that limits their ability to propel a manual wheelchair.




18 Years - 65 Years

Accepts Healthy Volunteers

Accepts Healthy Volunteers


Sarah R. Dubowsky, Ph.D., 973-243-6838, [email protected]

Location Countries

United States

Location Countries

United States

Administrative Informations



Organization ID


Study Sponsor

Kessler Foundation

Study Sponsor

Sarah R. Dubowsky, Ph.D., Principal Investigator, Kessler Medical Rehabilitation Research and Education Center

Verification Date

November 2008